From The Dean

Dean Marilyn SpeedieDear Alumni and Friends,

Mental health care access and quality for the rural and underserved areas of Minnesota is a major concern. At the College of Pharmacy, we believe pharmacists can play a major role in caring for these patients, working collaboratively with community mental health centers, psychiatrists, psychologists, mental health nurses and others.

Over the past year, Senior Associate Dean Randy Seifert has established a collaboration with Northern Pines Mental Health Center in Brainerd in which we can study how a model using pharmacists can best serve patients with both their primary care and chronic illness needs as well as their mental health medications.

Thanks to Laura Schwartzwald and her team at GuidePoint Pharmacy Services, we have been able to embed a resident into Northern Pines. Our goal is to provide patients in Northern Pines with comprehensive pharmacy services provided by a community pharmacy and to develop an interprofessional team within a behavioral health home. We believe this connection will demonstrate how effective community collaboration can improve outcomes for patients with serious mental illness.

For patients who have a mental illness, the team at Northern Pines is also able to provide primary care. However, with a pharmacist as part of that team, he or she is able to address and manage complex medication regimens, including psychiatric medications and medications for other chronic medical conditions.

People with serious mental illness have a shortened life expectancy and much of this reduced life span is the result of other medical illness, especially cardiovascular disease. In order to provide case-based learning, we have arranged for one of our psychiatric boarded pharmacist specialists to become a mentor, preceptor and peer reviewer in support of the team.

While our program with Northern Pines is the furthest along, we have other initiatives with other pharmacist groups across the region to address issues of better care for patients with serious mental illness. We have established a pharmacist training program in collaboration with Cindy Gunderson, Director of Pharmacy at the Red Lake Indian Health Service. Three pharmacists from Red Lake IHS will spend time in a didactic and experiential program with Mark Schneiderhan, our faculty at the Human Development Center in Duluth. We have established communication about potential educational, experiential and research collaborations with CentraCare in St. Cloud, Sanford Health in Bemidji, Northland Consulting in Grand Rapids and Northwest Passage Child & Adolescent Center in Frederic, Wisc.

Additionally, we have made some important connections with individuals within the Minnesota Department of Human Services and Department of Health. These are important because we have now determined a pathway for expanding the professional practice in the specialty of mental health care.

While we can bill for medication management services for several payers — mostly DHS programs, we are not consistently able to bill other managed Medicaid payers.

We are also not compensated for nondirect patient care coordination services and therefore are not included in the per member per month (PMPM) base rates for the Assertive Care Treatment teams and Behavioral Health Homes.

Our best chance of being able to be included in these base rates is to become designated mental health providers. This will take legislation and will require some sort of specialized training and certification. We may need to consider additional legislation that reduces discrimination between payers providing or not providing payment for medication therapy management services.

We have been invited to testify at the Legislative Healthcare Workforce Commission meeting on Dec. 6. At this session we will address the practice innovations of the college and how we plan to move forward to addressing health needs of Minnesotans.

The college is also working on ways to help provide all pharmacists with all of the tools they need to treat mental illness, including continuing professional education, mentorship and peer review support services. We have an opportunity to truly impact the lives of individuals with serious mental illness and address a critical need within Minnesota, especially rural areas of the state. I think if we can develop team-based and case-based learning experiences, we can train a very effective workforce to deliver improved access and care outcomes.

Marilyn K. Speedie, PhD
Dean
pharm@umn.edu